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* pituitary adenoma
 #138931  
  bijjar - 11/15/06 23:19
 
  A combination of elevated TSH, T3 and T4 levels is seen in TSH-secreting pituitary adenoma or thyroid hormone resistance syndrome. These disorders can be differentiated by measuring

A) Thyroid binding gobulin

B) Anti TPO

C) Alpha-subunit levels in the serum.

D) TRH

E) Prolactin
 
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* Re:pituitary adenoma
#560375
  chess1 - 11/15/06 23:48
 
  c)TSH alpha-subunits to total TSH is less than 1 in resistance syndrome.  
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* Re:pituitary adenoma
#560376
  knock_knock - 11/15/06 23:48
 
  ? D)  
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* Re:pituitary adenoma
#560516
  dr_nuri - 11/16/06 08:24
 
  c...  
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* Re:pituitary adenoma
#560852
  anila_indian - 11/16/06 13:14
 
  D  
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* Re:pituitary adenoma
#561589
  pedres - 11/16/06 21:29
 
  C MEASURE ALPHA SUB UNITS .  
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* Re:pituitary adenoma
#561597
  vitriol102 - 11/16/06 21:35
 
  I'd go with TRH, it's the easist...in TSH secreting adenoma, TRH would be low. If there is resistence, TRH would be high.  
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* Re:pituitary adenoma
#561982
  high - 11/17/06 08:22
 
  Logically thinking => D seems to be correct.
But upon text book searching and web searching => C is correct.

Here is from uptodate.com.
The following findings help to distinguish TSH-secreting adenomas from RTH (resistance to thyroid hormone):

The serum sex hormone-binding globulin concentration (SHBG) is high in patients with TSH-secreting pituitary adenomas, whereas the values are normal in RTH. This difference reflects the expected action of excess T4 and T3 on hepatic SHBG production in hyperthyroidism, and resistance to the hormones' action in RTH.
The serum alpha-subunit concentration is normal in RTH but, as noted above, often high in patients with TSH-secreting adenomas.
The serum TSH concentration increases in response to TRH in patients with RTH, but not in most patients with TSH-secreting adenomas.
Patients with RTH are more likely to have a fall in serum TSH concentrations in response to T3 (90 percent versus 12 to 25 percent)
 
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* Re:pituitary adenoma
#562188
  chinni - 11/17/06 10:55
 
  TRH  
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* Re:pituitary adenoma
#562490
  patrick_21 - 11/17/06 14:06
 
  TRH  
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* Re:pituitary adenoma
#562576
  bijjar - 11/17/06 14:46
 
  Ans is "C"

thanks high for high profile explaination.
 
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